Pancho - NAV-EDG-03

Code: NAV-EDG-03
Mercy ID: V-02903-21
Encounter Date: 01/21/2009
Last: Navarette
First: Edgar
DOB: 09/10/2003
County: Fulton
Street: 2225 Lenox Rd. Apt. 4
City: Atlanta
State: GA

Zip

30324-

Cell

(404) 791-8221

Family Status

Child/Youth

COB

Mexico

Gender

Male Child

Housing

Single Family

Education Level

Preschool

Home Owner

No

Parents Information

	Name	DOB	COB
Mother	Modesta Reyes	11/04/1977	Mexico
Father	Edgar Navarrete	11/16/1977	Mexico
Step Parent	N/A	N/A	N/A

Driver: No
Relative: No
Stranger: No
Lives With: Parents
Name of School: Easter Seals
Grade: Pre-K
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: C. Martinez
Data Entry: J. Manzo